Orange Envelope Application

If your child has been diagnosed with cancer within the last six months, please complete the information below so we can send an Orange Envelope gift to you and your All-Star

Pinky Swear processes applications monthly.

  • Applications are due the last day of the month, and reviewed and distributed the following month. For example, if you apply in February, your request will be reviewed in March.

  • Meeting the criteria in this application does not guarantee approval.

  • Pinky Swear will notify by email the primary contact and social worker listed whether or not your request was approved.

  • Orange Envelopes that are approved will be dispersed the last week of each month.

To complete the application you will need:

  • Your clinical social worker's contact information.

  • Please submit your applicaiton through the online form only. We can not accept fax or printed applications.

Patient Information
Cancer Information

Child must have been diagnosed within last six months to qualify for Orange Envelope. To apply for an Envelope Grant, click here.

Parent/Guardian Information
Other Parent / Guardian Information
Verifier Information